Bio

Clinical Focus

  • Pediatrics
  • Pediatric Hospital Medicine

Academic Appointments

  • Clinical Assistant Professor, Pediatrics

Administrative Appointments

  • Course Director, Pediatric Physical Findings, Stanford School of Medicine (2020 - Present)
  • Faculty Advisor, Pediatrics Interest Group, Stanford School of Medicine (2020 - Present)
  • Specialty Career Advisor, Pediatrics, Stanford School of Medicine (2020 - Present)
  • Faculty Coach, Stanford Pediatrics Residency Program (2019 - Present)
  • Co-Rotation Director, Blue Inpatient General Pediatrics Resident Rotation, Stanford School of Medicine (2018 - Present)

Honors & Awards

  • Division of Pediatric Hospital Medicine Door of Fame Recognition Award, Stanford School of Medicine (2019)
  • Honor Roll for Clinical Teaching, Pediatric Medical Student Clerkship, Stanford School of Medicine (2018, 2019)
  • Alpha Omega Alpha Honor Medical Society, Stanford School of Medicine (2018)
  • Letter of Distinction for Clinical Teaching, Pediatric Medical Student Clerkship, Stanford School of Medicine (2018)
  • Gold Humanism Honor Society, Baylor College of Medicine (2017)
  • Distinguished Resident Educator Award, Baylor College of Medicine (2016)
  • Martin J Lorin MD Best Teaching Resident Award, Baylor College of Medicine (2016)
  • Residency Advocacy Award, Doctors for Change, Baylor College of Medicine (2015)

Professional Education

  • Fellowship: Stanford Pediatric Hospital Medicine Fellowship (2019) CA
  • Board Certification, Pediatric Hospital Medicine, American Board of Pediatrics (2019)
  • Fellowship, Stanford School of Medicine, Pediatric Hospital Medicine Fellowship (2019)
  • Board Certification: American Board of Pediatrics, Pediatrics (2016)
  • Chief Residency, Baylor College of Medicine (2017)
  • Residency: Baylor College of Medicine Pediatric Residency (2016) TX
  • Medical Education: University of Texas Southwestern Medical Center (2013) TX

Contact

  • General Pediatrics 780 Welch Rd MC 5776 Stanford, CA 94305-5776
    • Tel: (650) 736-4423
    Fax: (650) 736-6690

Links

Research & Scholarship

Current Research and Scholarly Interests

Medical Education, Coaching, Shared Decision Making, Diversity/Inclusion, Human Trafficking

Teaching

2020-21 Courses

Publications

All Publications

  • Shared Decision-making With Parents of Hospitalized Children: A Qualitative Analysis of Parents' and Providers' Perspectives. Hospital pediatrics Hoang, K., Halpern-Felsher, B., Brooks, M., Blankenburg, R. 2020

    Abstract

    OBJECTIVES: Shared decision-making (SDM) is the pinnacle of patient-centered care and has been shown to improve health outcomes, especially for children with chronic medical conditions. However, parents perceive suboptimal involvement during hospitalization. The objective was to explore the perspectives of parents of hospitalized children and their hospital providers on facilitators and barriers to SDM in the hospital and identify strategies to increase SDM.METHODS: A qualitative study was conducted by using semistructured interviews with parents of hospitalized children with and without complex chronic conditions and their pediatric hospital medicine faculty. Parents and faculty were matched and individually interviewed on the same day. Two investigators iteratively coded transcripts and identified themes using modified grounded theory, with an additional author reviewing themes.RESULTS: Twenty-seven parents and 16 faculty participated in the interviews. Four themes emerged: (1) parents and providers value different components of SDM; (2) providers assume SDM is easier with parents of children with medical complexity; (3) factors related to providers, parents, patients, and family-centered rounds were identified as barriers to SDM; and (4) parents and providers identified strategies to facilitate SDM in the hospital.CONCLUSIONS: There is a discrepancy between parents' and providers' understanding of SDM, with parents most valuing their providers' ability to actively listen and explain the medical issue and options with them. There are many barriers that exist that make it difficult for both parties to participate. Several strategies related to family-centered rounds have been identified that can be implemented into clinical practice to mitigate these barriers.

    View details for DOI 10.1542/hpeds.2020-0075

    View details for PubMedID 33037030

  • EDUCATION JOURNAL OF HOSPITAL MEDICINE Blankenberg, R., Hoang, K. 2020; 15: 118?19

    View details for Web of Science ID 000538159300054

  • Addressing Goals of Parents of Hospitalized Children: A Qualitative Analysis of Parents' and Physicians' Perspectives. Academic pediatrics Hoang, K., Halpern-Felsher, B., Brooks, M., Blankenburg, R. 2020

    Abstract

    OBJECTIVE: Goals of care discussions are crucial in helping parents navigate complex medical decisions and shown to improve quality of care. Little is known about whether physicians elicit or address parents' goals during a child's hospitalization. The purpose of this study was to understand the current practice of goal setting at the beginning of hospitalization by exploring the perspectives of parents of hospitalized children and their hospital physicians.METHODS: A qualitative study with semi-structured interviews was conducted from 2018 to 2019 at a 361-bed quaternary suburban freestanding children's hospital. Twenty-seven parents of hospitalized children and sixteen pediatric hospital medicine faculty were matched to participate. Data was analyzed using modified grounded theory, with themes identified through constant comparative approach.RESULTS: Five themes were identified: 1) Majority of hospitalized children's parents want to share their goals with physicians. 2) Parents and physicians share the same underlying goal of getting the child better to go home. 3) Parents of children with chronic diseases identified non-hospital goals that were not addressed. 4) Physicians do not explicitly elicit but rather assume what parents' goals of care are. 5) Factors related to patient, parent, and physician were identified as barriers to goal setting.CONCLUSIONS: Physicians may not consistently elicit parents' goals of care for their hospitalized children at the start of hospitalization. Parents desire their physicians to explicitly ask about their goals and involve them in goal setting during hospitalization. Strategies were identified by parents and physicians to improve goal setting with parents of hospitalized children.

    View details for DOI 10.1016/j.acap.2020.05.016

    View details for PubMedID 32492580

  • A Previously Healthy Adolescent With Acute Psychosis and Severe Hyperhidrosis. Pediatrics Rosenblatt, T., Ort, K., Shaw, R., Levy, R. J., Chen, C., Niemi, A., Hoang, K. 2020

    Abstract

    A previously healthy 15-year-old boy presented with 3 months of progressive psychosis, insomnia, back and groin pain, and hyperhidrosis. On examination, the patient was disheveled, agitated, and soaked with sweat, with systolic blood pressure in the 160s and heart rate in the 130s. Aside from occasional auditory and visual hallucinations, his neurologic examination was normal. The patient was admitted for an extensive workup, including MRI of the brain and spine and lumbar puncture, which were normal. Through collaboration with various pediatric specialists, including psychiatry and neurology, a rare diagnosis was ultimately unveiled.

    View details for DOI 10.1542/peds.2019-3786

    View details for PubMedID 32444380

  • Teaching Conflict Resolution in Medicine: Lessons From Business, Diplomacy, and Theatre. MedEdPORTAL : the journal of teaching and learning resources Wolfe, A. D., Hoang, K. B., Denniston, S. F. 2018; 14: 10672

    Abstract

    Introduction: Disagreement and conflict are inevitable among members of clinical teams, as well as with patients and families during the course of medical care. Despite the importance of physicians needing to negotiate and resolve conflicts, best practices for teaching these skills have not been established in a clinical setting.Methods: We developed teaching tools based on a conflict resolution model from the business world, emphasizing team dynamics and employing a structured, hierarchical approach to conflict resolution that preserves interpersonal relationships. We employed lessons from diplomacy and improvisational theatre to underscore nonverbal cues that improve communication during conflict. We prepared instructions for teaching conflict management and conflict resolution styles, small-group negotiations, case-based clinical scenarios, personal reflection, and facilitated debrief. The tools are customizable based on audience and available instructional time.Results: We implemented this resource for over 2 years with 20 pediatric residents and over 150 educators and fellows at national meetings. Participants reported that the topic was timely and important and identified the conflict resolution hierarchy, attention to conflict resolution styles, use of case-based discussion, and focus on nonverbal communication as effective and valuable elements.Discussion: This resource has been refined over five cycles of presentation and feedback with learners and educators. Our participants identified themes of conflicts in clinical settings that informed the case scenarios presented here, including interdisciplinary conflicts, ethical conflicts, and conflicts among members of the educational hierarchy. These tools are designed to meet established national educational priorities related to communication and professionalism across the educational continuum.

    View details for PubMedID 30800872

  • Implementation of a Prehospital Protocol Change For Asthmatic Children PREHOSPITAL EMERGENCY CARE Nassif, A., Ostermayer, D. G., Hoang, K. B., Claiborne, M. K., Camp, E. A., Shah, M. I. 2018; 22 (4): 457?65

    Abstract

    Respiratory distress due to asthma is a common reason for pediatric emergency medical services (EMS) transports. Timely initiation of asthma treatment, including glucocorticoids, improves hospital outcomes. The impact of EMS-administered glucocorticoids on hospital-based outcomes for pediatric asthma patients is unknown.The objective of this study was to evaluate the effect of an evidence-based pediatric EMS asthma protocol update, inclusive of oral glucocorticoid administration, on time to hospital discharge.This was a retrospective cohort study of children (2-18 years) with an acute asthma exacerbation transported by an urban EMS system to 10 emergency departments over 2 years. The investigators implemented an EMS protocol update one year into the study period requiring glucocorticoid administration for all patients, with the major change being inclusion of oral dexamethasone (0.6 mg/kg, max. dose = 10 mg). Protocol implementation included mandatory paramedic training. Data was abstracted from linked prehospital and hospital records. Continuous data were compared before and after the protocol change with the Mann-Whitney test, and categorical data were compared with the Pearson ?2 test.During the study period, 482 asthmatic children met inclusion criteria. After the protocol change, patients were more likely to receive a prehospital glucocorticoid (11% vs. 18%, p = 0.02). Median total hospital time after the protocol change decreased from 6.1 hours (95% CI: 5.4-6.8) to 4.5 hours (95% CI: 4.2-4.8), p < 0.001. Total care time, defined as time from ambulance arrival to hospital discharge, also decreased [6.6 hours (95% CI: 5.8-7.3) vs. 5.2 hours (95% CI: 4.8-5.6), p = 0.01]. Overall, patients were less likely to be admitted to the hospital (30% vs. 21%, p = 0.02) after the change. Those with more severe exacerbations were less likely to be admitted to a critical care unit (82% vs. 44%, p = 0.02) after the change, rather than an acute care floor.Prehospital protocol change for asthmatic children is associated with shorter total hospital and total care times. This protocol change was also associated with decreased hospitalization rates and less need for critical care in those hospitalized. Further study is necessary to determine if other factors also contributed.

    View details for DOI 10.1080/10903127.2017.1408727

    View details for Web of Science ID 000436977600009

    View details for PubMedID 29351496

  • Pediatricians' Communication About Weight With Overweight Latino Children and Their Parents PEDIATRICS Turer, C. B., Montano, S., Lin, H., Hoang, K., Flores, G. 2014; 134 (5): 892?99

    Abstract

    To examine pediatrician weight-management communication with overweight Latino children and their parents and whether communication differs by pediatrician-patient language congruency.Mixed-methods analysis of video-recorded primary care visits with overweight 6- to 12-year-old children. Three independent reviewers used video/transcript data to identify American Academy of Pediatrics-recommended communication content and establish communication themes/subthemes. Language incongruence (LI) was defined as pediatrician limited Spanish proficiency combined with parent limited English proficiency (LEP). Bivariate analyses examined associations of LI with communication content/themes.The mean child age (N = 26) was 9.5 years old; 81% were obese. Sixty-two percent of parents had LEP. Twenty-seven percent of pediatricians were Spanish-proficient. An interpreter was used in 25% of LI visits. Major themes for how pediatricians communicate overweight included BMI, weight, obese, chubby, and no communication (which only occurred in LI visits). The pediatrician communicated child overweight in 81% of visits, a weight-management plan in 50%, a culturally relevant dietary recommendation in 42%, a recommendation for a follow-up visit in 65%, and nutrition referral in 50%. Growth charts were used in 62% of visits but significantly less often in LI (13%) versus language-congruent (83%) visits (P < .001).Many overweight Latino children do not receive direct communication of overweight, culturally sensitive dietary advice, or follow-up visits. LI is associated with a lower likelihood of growth chart use. During primary care visits with overweight Latino children, special attention should be paid to directly communicating child overweight, formulating culturally sensitive weight-management plans, and follow-up. With LEP families, vigilance is needed in providing a trained interpreter and using growth charts.

    View details for DOI 10.1542/peds.2014-1282

    View details for Web of Science ID 000344385900037

    View details for PubMedID 25311599

    View details for PubMedCentralID PMC4210795

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